Background/Objectives: The Portuguese health system is characterized by universal coverage through the National Health Service (SNS) alongside the presence of private healthcare providers. We aim to assess the association between health service utilization and sociodemographic characteristics.

Methods: Data were collected in 2025 through a random-digit-dialing (RDD) telephone survey, resulting in 143 completed questionnaires. To compare the prevalence of use in the last year for each type of public and private services, McNemar’s test was used. Adjusted odds ratios and respective 95%CI were used to measure the associations between the type of health service used in the last year and sociodemographic characteristics.

Results: Primary care centers were the most frequently used services (74.8%), followed by public hospitals (47.6%) and private hospitals (38.5%). Individuals with University level educational attainment used private hospitals (OR = 5.35, 95%CI: 1.96-15.86) and medical private offices (OR = 6.27, 95%CI: 1.79-26.25) more often than those with less formal education. Older respondents (> 65 years) showed higher use of primary care centers (OR = 10.91, 95%CI: 2.09-86.23). About 78% had an assigned family physician and no association were found with sex, age and education. However, there were disparities by place of residence, with Lisbon having the lowest coverage at only 61%. Preventive consultations were common (61% attended even without any disease or health-related condition) and 92% reported at least one screening in the past two years. The main source of medical information were primary care centers (53%) and was associated to older adults (OR = 9.42, 95%CI: 2.50-40.41).

Conclusions/Recommendations: Health service utilization in Portugal shows distinct sociodemographic and regional patterns, as educational attainment, age, and place of residence are strong determinants of the type of service used and the types of access to information and care. The Portuguese health system has historically been centered on the National Health Service (SNS). However, these findings show a progressive shift toward a more balanced model combining public and private care.

Funding: Health from Portugal (HfPT), Work Package 06 (WP06), Project PPS 6.1.